Fentanyl: a threat to Brazilian society or an opioid drug of great importance in pain management?

Abstract

Introduction: About 450,000 Americans died from opioid overdoses between 1999-2018, characterizing one of the worst public health problems ever faced by the U.S. Methods: A narrative literature review was carried out with a search in the main databases. A total of 101 studies were selected and after analysis were reduced to 77 articles that allowed a comprehensive view of Fentanyl in the USA and the factors that triggered its high-risk consumption and the consequences in Brazil. Results and Discussion: Three phases have been identified that have contributed to the opioid crisis in the U.S.: increased prescribing; heroin use associated with other drugs, especially fentanyl and illicit fentanyl use. In Brazil, in contrast to a history of opiophobia, there has been an increase in opioid prescriptions and seizures of illicit fentanyl. The impact of this increase is unknown in relation to the high-risk/addiction consumption scenario. Final considerations: Fentanyl represents a valuable tool in pain management and cannot be excluded from clinical practice. This is justified by the social and bioethical responsibility associated with pain control. It is essential to establish control mechanisms and prevention measures to ensure access to medicines while preventing their illegal circulation.